Goswami Upasana, Babbar Savita, Tiwari Saurabh
Department of Anaesthesiology, Deen Dayal Upadhyay Hospital, New Delhi, India.
Indian J Anaesth. 2015 Mar;59(3):150-5. doi: 10.4103/0019-5049.153036.
General anaesthesia (GA) may cause post-operative impairment of cognition and memory. This is of importance where time to discharge after anaesthesia is short as after laparoscopic cholecystectomy. This study was conducted to compare the effects of propofol and sevoflurane on cognitive function in the post-operative period.
After approval of the Ethical Committee, 80 female patients posted for laparoscopic cholecystectomy to be performed under GA were randomly divided into two groups. Propofol was used in Group P and sevoflurane in Group S. Data analysis was done with California verbal learning test (CVLT), digit span test (DST), Rivermead behavioural memory test (RBMT), mini mental state examination (MMSE) score, and semantic memory tests. Aldrete recovery scoring system and visual analogue scale for pain were assessed post-operatively. The level of statistical significance was set at P < 0.05.
There was no significant difference in demographic and haemodynamic data. Cognition and explicit memory were affected more in the propofol group in the immediate post-operative period. With majority of tests, such as semantic memory test, MMSE score, DST and RBMT, the difference was insignificant at 2 and 4 h post-operatively. But CVLT values were found to be statistically significant between groups even at 4 h.
Propofol was associated with significant impact on cognitive functions in comparison to sevoflurane in the immediate post-operative period. Sevoflurane anaesthesia might be a better option in day care surgeries.
全身麻醉(GA)可能导致术后认知和记忆功能受损。在麻醉后出院时间较短的情况下,如腹腔镜胆囊切除术后,这一点尤为重要。本研究旨在比较丙泊酚和七氟醚对术后认知功能的影响。
经伦理委员会批准,80例计划在全身麻醉下进行腹腔镜胆囊切除术的女性患者被随机分为两组。P组使用丙泊酚,S组使用七氟醚。采用加利福尼亚言语学习测验(CVLT)、数字广度测验(DST)、里弗米德行为记忆测验(RBMT)、简易精神状态检查表(MMSE)评分和语义记忆测验进行数据分析。术后采用Aldrete恢复评分系统和视觉模拟疼痛量表进行评估。统计学显著性水平设定为P < 0.05。
两组患者的人口统计学和血流动力学数据无显著差异。丙泊酚组在术后即刻认知和外显记忆受到的影响更大。在大多数测试中,如意义记忆测试、MMSE评分、DST和RBMT,术后2小时和4小时差异无统计学意义。但即使在术后4小时,两组间的CVLT值仍具有统计学显著性。
与七氟醚相比,丙泊酚在术后即刻对认知功能有显著影响。在日间手术中,七氟醚麻醉可能是更好的选择。